Physical Activity

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Full Title: Effectiveness of Behavioral Interventions to Modify Physical Activity Behaviors in General Populations and Cancer Patients and Survivors

Structured Abstract

Objectives: A systematic review of the literature to address:

What is the evidence that physical activity interventions alone, or combined with diet modification or smoking cessation, are effective in helping individuals sustainably increase their aerobic physical activity?

Is the effectiveness of theoretically based interventions different?

Do hypothesized moderators affect the results of these interventions?

Do these interventions affect theoretically hypothesized mediators?

In these interventions, is there a relationship between changes in theoretically hypothesized mediators and changes in physical activity?

What is the evidence that physical activity interventions, alone or combined with diet
modification or smoking cessation, are effective in helping cancer survivors improve their psychosocial or physiological outcomes?

Question 1: Studies with at least 75 generally healthy subjects with an intervention to increase physical activity and activity measured at least three months after the intervention.

Question 2: Studies of adults with cancer or survivors with an intervention to increase physical activity with a measure of activity.

Results: The range of populations, interventions, and outcomes in the included studies, as well as inadequacy of information provided, did not allow pooling of studies. Results were examined semi-quantitatively using whether a study was positive, significant, and, when possible, its effect size. Forty-five percent of the studies had at least one statistically significant outcome; 5.9 percent had an effect size greater than .8 and 5.9 percent were between .5 and .8. There were no clear patterns in results by setting, intensity, interventions using theory, combined interventions, and those that addressed accessibility, possibly due to the small number of studies. Physical activity interventions in the cancer survivor populations were found to have multiple beneficial effects. The most consistent and strong findings were positive effects on vigor/vitality, cardiorespiratory fitness, quality of life, depression, anxiety, and fatigue.

Conclusions: Overall, this literature is positive, but the relative magnitude of the effect is difficult to judge given the wide range of outcomes examined. The field would benefit from standardized measures and more studies examining longer outcomes. The 24 interventions reviewed indicate that physical activity is safe for cancer survivors and consistently results in improved physiologic and psychosocial outcomes.

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Effectiveness of Behavioral Interventions to Modify Physical Activity Behaviors in General Populations and Cancer Patients and Survivors